Note: Marshmallow is not to be confused with mallow leaf, mallow flower, or confectionery marshmallows; although confectionery marshmallows were once made from the Althaea officinalis plant, they now primarily contain sugar.

Both marshmallow leaf and root are used in commercial products. Herbal formulas are made from either the dried root or leaf (unpeeled or peeled). The actual content of the commercial product depends on the time of collection.

There is a lack of evidence to support the use of marshmallow alone for any condition. The medical uses of marshmallow are supported by traditional use and early research. Limited human evidence is available on the effectiveness of marshmallow-containing products for skin conditions.

Marshmallow may affect the way the body absorbs some medications taken by mouth. Marshmallow should be consumed several hours before or after other medicinal agents.

Marshmallow is generally considered safe. However, allergic reactions or low blood sugar have been reported.

These uses have been tested in humans or animals. Safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider.

GRADE *

Marshmallow has been studied for the treatment of coughs caused by ACE inhibitors, agents that treat high blood pressure and other heart conditions. Early research suggests that marshmallow may help prevent coughing by forming a protective coating in the lungs. However, more evidence is needed to confirm the effectiveness of marshmallow in humans.

C

Marshmallow may help treat infections from parasites. Marshmallow preparations have been used in combination with steroids for skin conditions. The plant is believed to have anti-inflammatory activity that increases the effect of steroids applied to the skin. Further research is needed to confirm these findings.

C

Marshmallow extracts have been applied to the skin to treat inflammation. However, research is limited in this area. More information is needed before a firm conclusion can be made.

C

* Key to grades

A: Strong scientific evidence for this useB: Good scientific evidence for this useC: Unclear scientific evidence for this useD: Fair scientific evidence for this use (it may not work)F: Strong scientific evidence against this use (it likley does not work)

Tradition / Theory
The below uses are based on tradition, scientific theories, or limited research. They often have not been thoroughly tested in humans, and safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider. There may be other proposed uses that are not listed below.

Marshmallow has been taken by mouth daily in doses of 5 grams of leaf or equivalent preparation or 6 grams of root or equivalent preparation. Use caution in people taking other medications by mouth, as marshmallow may affect the body's absorption of these agents.

For coughs (associated with blood pressure medications), 20-40 milligrams of marshmallow (given as 20 drops) has been taken by mouth three times daily for four weeks.

Doses of 5-10 grams of marshmallow in an ointment or cream, or 5 percent powdered marshmallow leaf, have been applied to the skin three times daily.

As a gargle for mouth and throat irritation, 2 grams of marshmallow has been soaked in one cup of cold water for two hours before gargling.

Children (younger than 18 years)

There is no proven safe or effective dose for marshmallow in children.

Safety
The U.S. Food and Drug Administration does not strictly regulate herbs and supplements. There is no guarantee of strength, purity or safety of products, and effects may vary. You should always read product labels. If you have a medical condition, or are taking other drugs, herbs, or supplements, you should speak with a qualified healthcare provider before starting a new therapy. Consult a healthcare provider immediately if you experience side effects.

Allergies

Avoid in people with known allergy or sensitivity to marshmallow (Althaea officinalis), its parts, or members of the Malvaceae family.

Side Effects and Warnings

Marshmallow is likely safe when taken by mouth in food amounts.

Marshmallow is possibly safe when taken by mouth or applied to the skin in recommended doses for medical purposes.

Marshmallow may cause allergic reactions or changes in the body's absorption of medications.

Marshmallow may lower blood sugar levels. Caution is advised in people with diabetes or low blood sugar, and in those taking drugs, herbs, or supplements that affect blood sugar. Blood sugar levels may need to be monitored by a qualified healthcare professional, including a pharmacist, and medication adjustments may be necessary.

Use cautiously in people who are taking other medications by mouth or steroids applied to the skin.

Use cautiously in children and in pregnant or breastfeeding women, due to a lack of safety information.

Avoid in people with known allergy or sensitivity to marshmallow (Althaea officinalis), its parts, or members of the Malvaceae family.

Pregnancy and Breastfeeding

There is a lack of scientific evidence on the use of marshmallow during pregnancy or breastfeeding. Use cautiously in women who are pregnant or breastfeeding.

Marshmallow may lower blood sugar levels. Caution is advised when using medications that may also lower blood sugar. People taking drugs for diabetes by mouth or insulin should be monitored closely by a qualified healthcare professional, including a pharmacist. Medication adjustments may be necessary.

Marshmallow may also interact with ACE inhibitors, agents that affect the immune system, agents that are taken by mouth, agents used for the stomach and intestines, agents used to treat cough, antibiotics, anti-inflammatory agents, antimicrobial agents, antiprotozoals, and steroids applied to the skin.

Interactions with Herbs and Dietary Supplements

Marshmallow may lower blood sugar levels. Caution is advised when using herbs or supplements that may also lower blood sugar. Blood glucose levels may require monitoring, and doses may need adjustment.

Marshmallow may also interact with antibacterials, anti-inflammatory herbs and supplements, antimicrobial herbs and supplements, antiprotozoals, herbs and supplements that are taken by mouth, and herbs and supplements used to treat cough.

The information in this monograph is intended for informational purposes only, and is meant to help users better understand health concerns. Information is based on review of scientific research data, historical practice patterns, and clinical experience. This information should not be interpreted as specific medical advice. Users should consult with a qualified healthcare provider for specific questions regarding therapies, diagnosis and/or health conditions, prior to making therapeutic decisions.